Commonly Asked Questions – Asthma Control Assessment

Commonly Asked Questions – Asthma Control Assessment

I worked on an asthma program this last weekend.  I was reviewing the GINA asthma guidelines for this project.  They have simplified the assessment of asthma control and allow us to assess if the person with asthma is fully controlled, partially controlled or uncontrolled in a matter of a couple of minutes.

Each of the asthma assessment tools provided below can quickly assess asthma control of people with asthma.  By having patients complete these tools, clinicians can determine if the patient needs intensification in therapy.  I really like the GINA asthma symptom assessment tool as it is quick and can assess full, partial or poor control. 

30 Second Asthma Test

The 30 Second Asthma Test has been used in Canada for years.  It has 5 questions to assess if a person has his/her asthma under control.  If the person answers yes to any of these questions, this could indicate sub- optimal control. 

  1. Do you cough, wheeze, or have a tight chest because of your asthma? (3 or more times a week)
  2. Do coughing, wheezing, or chest tightness wake you at night? (1 or more times a week)
  3. Do you stop exercising because of your asthma (in the past 3 months)
  4. Do you ever miss work, school, social activities because of your asthma? (in the past 3 months
  5. Do you use your fast-acting reliever inhaler 4 or more times a week?

A key change is the doses of fast-acting reliever also include any dose given prior to exercise.

Asthma Control Test (ACT)

The Asthma Control Test (ACT) is a 5 question test that assesses asthma control over the last 4 weeks.  For each question, the patient scores 1 to 5 depending on the level of impairment or asthma symptoms.

The ACT score can range from 5-25.  The higher the score the better.

Level of asthma control is based on the score:

  1. Score 20-25 – is classified as well-controlled asthma
  2. Score 16-19 – is classified as partial control (or not well-controlled)
  3. Score 5-15 – is classified as very poorly controlled asthma

GINA Asthma Assessment Test

The 2018 GINA Asthma Guidelines have a very simple asthma assessment test. The four questions include:

  1. Daytime asthma symptoms more than twice/week?
  2. Any night waking due to asthma?
  3. Reliever needed for symptoms more than twice/week?
  4. Any activity limitation due to asthma?

Scoring of the GINA assessment test:

  • Well controlled – answer no to all of these questions
  • Partly controlled – Answer yes to 1 to 2 of these questions
  • Uncontrolled – Answer yes to 3 to 4 of these questions